For nearly four decades, food banks have provided a vital link between food and families in need. Today, more than 200 food banks across the United States distribute millions of tons of provisions to more than 46 million people, or more than 14 percent of the US population. These hubs supply food pantries, churches, and other charities with their offerings for hunger relief, and thereby shape the food ecosystem for low-income America.
Food banks have largely defined their challenge as lack of food. In response, we have collected large quantities—including junk food—distributed it, and measured our success by pounds of output. While bellies have been filled, we have missed a real opportunity to improve the diet and health of those we serve.
In fact, we may have unwittingly made people’s health worse by failing to appreciate the power of food to prevent the troika of diet-related diseases plaguing low-income America: diabetes, heart disease, and obesity. In recent years, the Capital Area Food Bank (CAFB), which I head, has learned that 49 percent of the people we reach have heart disease or live with someone who does, and 23 percent have diabetes or live with someone who does.
This past March, the CAFB hosted the 60th-anniversary celebration of the President’s Council on Fitness, Sports, and Nutrition at our Washington, D.C. distribution center. Local chefs demonstrated simple, healthy recipes such as tuna tacos to elementary school kids.
As then-US Surgeon General Vivek Murthy toured our warehouse and discussed our work, a member of his staff leaned over and whispered, “I didn’t realize your food bank was a public health organization.” The comment made me realize that we had to be even bolder and more explicit about our true mission: enabling diet-related health as we address hunger.
Good food can help prevent diabetes and heart disease, and, paired with exercise and other habits, it can reduce the prevalence of obesity. With this knowledge, food banks must redefine the problem they are trying to solve. The issue is not just lack of food, but lack of access to nutritious food such as fresh fruits and vegetables across large swaths of America where low-income people reside. Solving this problem requires a radical rethinking of how food banks operate, what they value, and how they measure success.
Food as a Health Tool
Food banks began in the United States in the 1970s to provide local emergency relief to families experiencing hunger and multiplied in the early ’80s after the Reagan administration cut federal assistance for the nutrition program then called Food Stamps (nowadays known as the Supplemental Nutrition Assistance Program, or SNAP). Faith-based organizations strove to fill the gap by collecting food—mostly canned goods—and distributing it to those in need.
In the four decades since, as wages have failed to keep pace with inflation and the gap between rich and poor has widened, food banks have become a regular food source for the working poor and unemployed. According to Feeding America, 50 percent of the 46 million people served by food banks nationally belong to working families, in which at least one family member has been employed during the year. Here in Washington, 56 percent of the people that CAFB serves belong to working families. The typical client of the food bank turns to us for food nine times a year.
While food needs have increased, society at large—led by the medical community—has come to better understand the powerful link between food and health. Food not only sustains us, but also helps prevent the two greatest scourges on our health—diabetes and heart disease—on which Americans every year spend $101 billion and $88 billion, respectively.
If food banks are truly to serve their communities, we must see food as the chief tool to prevent diabetes and heart disease. This will require cleaning up our inventories and helping people form good food habits. We at CAFB have taken this path, and while we have a way to go, we have made progress.
In 2013, we embedded health and wellness in our strategic plan with the explicit objective to “contribute to health and wellness as we provide more nourishing food across the Washington metro area.” This paved the way for a host of operational, policy, and communications decisions that cemented the tie between food and health.
We aligned our operational practices with our goals by getting our nutrition experts out of their silos and into operations. The staff of the Healthy Eating department, once a self-contained team championing nutrition education, moved on to core teams throughout the organization. The team’s dietitian and other senior staff were moved to our Food Resources division to lead the food bank’s donation sourcing and procurement.
With more hands-on access to our inventory, our nutritionist led the development of a wellness tracker that measures added sodium, added sugar, and fiber in our food. We began classifying our food as “wellness” or “non-wellness” based on thresholds for those three nutrients. In three years, we have increased the percentage of wellness food to 82 percent from 69 percent. Working closely with our retail donors, we began to identify and reduce donations that we were receiving in excess, such as sodas, cakes, and candies. Ultimately, we redefined our food acceptance policy to reject these items.
We also developed a trove of information and trainings to pair with the food we distribute, such as more than 100 simple, nutritious, low-cost recipe cards (on paper and online); produce guides with information about fresh produce preparation and storage; and, with an eye toward scalability, a train-the-trainer curriculum that equips CAFB food-assistance partners with the knowledge and tools needed to promote health.
A big moment came when we realized we were packing too much information into “nutrition education.” We saw that people either already knew how much potassium bananas had or did not care. They did, however, want to know that the purple thing was an eggplant and that if you chop it, add an onion and a can of low-salt tomatoes, and cook it over low heat, it becomes something delicious and good for you. We are now working to amplify the power of produce with information about how to use it.
How to Count Pounds
How have food banks gotten their mission so wrong for so long? Hunger-relief organizations measure pounds because it is easy: Weight is a clear indicator of output. And since pounds can readily be turned into meals, pounds appeal to those hungry for quantifiable achievement.
But soda weighs more than leafy greens, which means it produces more output. For that reason, CAFB no longer uses simple pounds of food as the measure of success. In 2014, we eliminated full-calorie sodas from our inventory, cutting an estimated 2 million pounds of distribution. Eliminating bakery items and leftover candy has shed many more pounds. The next year we added $80,000 to the budget to purchase leafy greens. This step lowered our overall weight output but boosted our health impact vis-à-vis soda.
This is not to say we have given up on weight as a measure. Instead, we’ve refined it. We now measure the following: pounds of produce distributed per person; pounds of wellness food distributed; wellness pounds donated by retailers; wellness pounds ordered by partners; and vegetable consumption among students and families, to gauge the success of our school-based markets.
Leaders in the food-banking community often talk about nutrition without confronting the challenges in their inventories, because they are afraid of alienating donors. Food companies have for decades donated what they do not sell. Food banks fear that companies will quit donating if they screen donations for quality.
But this has not been our experience at CAFB. Early in my tenure, I noticed that our warehouse looked as if it were on the verge of exploding from the sheer volume of sheet cake. I learned that the buildup resulted from our decision to limit the percentage of sugary, processed snacks (candy, bakery goods, etc.) on any one distribution of food to the community. In other words, we had an excess supply problem.
In this case, the sheet cakes had come from Shoppers Food Warehouse, so I wrote to its president, Bob Gleeson. He invited me to headquarters the following week. I thanked him for being a generous donor but added that we were getting more sheet cake than we could distribute in good conscience. His reply was swift: “I don’t want to be giving you food you don’t want, and don’t want to be overproducing sheet cake.” Shoppers then established policies and practices that allowed them to sort bakery goods out of the donations that they sent the food bank.
We had a similar experience with Giant Food. When its regional president Gordon Reid joined our board in 2015, I asked whether Giant would be willing to pilot “Retailers for Wellness,” a partnership with retailers to drive healthier donations and other innovative wellness solutions. He agreed. Over the span of two years, Giant has begun sorting out soda, bakery items, and candy from their donations; increased the amount of frozen protein that it donates; made CAFB-Giant co-branded recipes available in its 92 stores throughout the Washington metro area; and made more healthy food available to those we serve by creating readymade boxes of nutritious items for customers to purchase and donate at checkout.
To transform food donors from allies in the fight against hunger into partners in community wellness, food banks must smash conventional wisdom against the rocks. Donors will not stop giving if we ask them to prioritize food that contributes to health. In fact, food companies will welcome the opportunity to improve the health of America and receive well-deserved credit for it.
Food banks remain a critical part of hunger relief for our country. But we can no longer consider ourselves the sole solution to lack of food access and measure our success simply by pounds of food distributed. Food banks must work with produce companies to distribute more and better produce. We must bring fruits and vegetables to schools to help build good habits among children and their families. We must build a bridge to affordable retail access. And we must work hand in hand with retailers, governments, nonprofits, and those we serve toward a future of good food—and good health—for all.